African Journal of Parasitology, Mycology and Entomology

Introduction: Head lice infestations are widespread in Senegal and widely distributed throughout the world with high proportions. Recent studies involving classical treatment modalities and alternative ivermectin treatment indicated the existence of an ivermectin-resistant head lice population. Method: Our study involved oral combination of ivermectin with azithromycin to prevent mutant-resistant lice to treatment with oral ivermectin alone. Each infested participant weighing at last 15 kg was administered orally a single dose of 333 µg/kg of ivermectin combined with one or two 250 mg tablets of azithromycin and/or one 500 mg, repeated on day 7 if lice infestation persisted. Result: Of 315 participants, 308 and 304 patients were respectively followed-up on days 7 and 15, with a respective reduction in infestation of 27.6% and an effectiveness of 66.4% (p ˂ 0.001). On day 28, 280 were no longer infested with lice or living eggs, revealing 96.2% (280/291) effectiveness (p ˂ 0.001) achieved without any participant stopping treatment. Conclusion: After conducting PCR-RFLP assays and sequencing the two mutation sites, no mutation for either polymorphism occurred and no resistant lice were found. Resistant lice subjected to oral ivermectin treatment alone is not likely to be apparent in an infested population treated with oral ivermectin and azithromycin combination. Full article